Aya Niimi1, Motofumi Suzuki2, Yasuhiro Yamaguchi3, Masaki Ishii4, Tetsuya Fujimura1, Tohru Nakagawa1, Hiroshi Fukuhara1, Haruki Kume1, Yasuhiko Igawa5, Masahiro Akishita4, Yukio Homma1. 1. Department of Urology, Graduate School of Medicine, University of Tokyo, Tokyo, Japan. 2. Department of Urology, Tokyo Teishin Hospital, Tokyo, Japan. 3. Department of Geriatric Medicine, Graduate School of Medicine, University of Tokyo, Tokyo, Japan. Electronic address: yamayasu-tky@umin.ac.jp. 4. Department of Geriatric Medicine, Graduate School of Medicine, University of Tokyo, Tokyo, Japan. 5. Department of Continence Medicine, Graduate School of Medicine, University of Tokyo, Tokyo, Japan.
Abstract
PURPOSE: We investigated the relationships among nocturnal polyuria, sleep apnea and body fluid volume to elucidate the pathophysiology of nocturia in sleep apnea syndrome. MATERIALS AND METHODS: We enrolled 104 consecutive patients who underwent polysomnography for suspected sleep apnea syndrome. Self-assessed symptom questionnaires were administered to evaluate sleep disorder and lower urinary tract symptoms, including nocturia. Voiding frequency and voided volume were recorded using a 24-hour frequency-volume chart. Body fluid composition was estimated in the morning and at night using bioelectric impedance analysis. Frequency-volume chart data were analyzed in 22 patients after continuous positive airway pressure therapy. RESULTS: Patients with nocturnal polyuria showed a higher apnea-hypopnea index (33.9 vs 24.2, p = 0.03) and a larger circadian change in extracellular fluid adjusted to lean body mass (0.22 vs -0.19, p = 0.019) than those without nocturnal polyuria. These relations were more evident in patients 65 years old or older than in those 64 years or younger. A multivariate linear regression model showed an independent relationship of nocturnal polyuria with the apnea-hypopnea index and the circadian change in extracellular fluid adjusted to lean body mass (p = 0.0012 and 0.022, respectively). Continuous positive airway pressure therapy significantly improved nocturnal polyuria and nocturia only in patients with nocturnal polyuria. CONCLUSIONS: This study identified sleep apnea and the circadian change in extracellular fluid as independent factors for nocturnal polyuria.
PURPOSE: We investigated the relationships among nocturnal polyuria, sleep apnea and body fluid volume to elucidate the pathophysiology of nocturia in sleep apnea syndrome. MATERIALS AND METHODS: We enrolled 104 consecutive patients who underwent polysomnography for suspected sleep apnea syndrome. Self-assessed symptom questionnaires were administered to evaluate sleep disorder and lower urinary tract symptoms, including nocturia. Voiding frequency and voided volume were recorded using a 24-hour frequency-volume chart. Body fluid composition was estimated in the morning and at night using bioelectric impedance analysis. Frequency-volume chart data were analyzed in 22 patients after continuous positive airway pressure therapy. RESULTS:Patients with nocturnal polyuria showed a higher apnea-hypopnea index (33.9 vs 24.2, p = 0.03) and a larger circadian change in extracellular fluid adjusted to lean body mass (0.22 vs -0.19, p = 0.019) than those without nocturnal polyuria. These relations were more evident in patients 65 years old or older than in those 64 years or younger. A multivariate linear regression model showed an independent relationship of nocturnal polyuria with the apnea-hypopnea index and the circadian change in extracellular fluid adjusted to lean body mass (p = 0.0012 and 0.022, respectively). Continuous positive airway pressure therapy significantly improved nocturnal polyuria and nocturia only in patients with nocturnal polyuria. CONCLUSIONS: This study identified sleep apnea and the circadian change in extracellular fluid as independent factors for nocturnal polyuria.
Authors: Soner Coban; Aygul Gunes; Abdullah Gul; Ali Riza Turkoglu; Muhammet Guzelsoy; Murat Ozturk; Osman Akyuz; Ozgur Ekici Journal: Investig Clin Urol Date: 2020-09-24